The Impact of Alcohol on PrEP Adherence in Vulnerable Men

酒精对弱势男性 PrEP 依从性的影响

• 批准号: 10161276
• 负责人: Drew Anne Westmoreland
• 金额: $ 19.96万
• 依托单位: GRADUATE SCHOOL OF PUBLIC HEALTH AND HEALTH POLICY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-28 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10161276
• 关键词: AIDS prevention; Adherence; Age; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; American; Attitude; Back; Belief; Bisexual; Blood; Color; Communication; Complex; Continuity of Patient Care; Data; Data Analyses; Data Collection; Decision Making; Diagnosis; Dose; Ecological momentary assessment; Educational workshop; Enrollment; Epidemic; Epidemiologist; FDA approved; Formulation; Fumarates; Gays; General Population; Goals; Grant; Growth; HIV; HIV Seronegativity; HIV Seropositivity; HIV risk; HIV/STD; Health behavior; Incidence; Individual; Infection; Intervention; Interview; K-Series Research Career Programs; Lead; Link; Literature; Mentored Research Scientist Development Award; Mentors; Mentorship; Methodology; Methods; Monitor; National Institute on Alcohol Abuse and Alcoholism; Outcome; Participant; Pathway interactions; Patient Self-Report; Pattern; Perception; Persons; Pharmaceutical Preparations; Play; Population; Prevention Research; Prevention strategy; Principal Investigator; Public Health; Publishing; Qualitative Research; Research; Research Methodology; Research Personnel; Research Priority; Risk; Risk Behaviors; Role; Sampling; Schedule; Sex Behavior; Sexual Health; Sexual Partners; Specimen; Spottings; Surveys; Techniques; Tenofovir; Testing; Time; TimeLine; Toxic effect; Training; United States; Viral; Writing; alcohol effect; alcohol measurement; alcohol misuse; alcohol research; alcohol testing; alcohol use disorder; career; career development; condomless anal sex; condoms; contextual factors; data collection methodology; diaries; drinking; emtricitabine; experience; follow-up; high risk; implementation science; improved; knowledge base; meetings; men; multiple data sources; pill; pre-exposure prophylaxis; prevent; racial and ethnic; sex; sexual risk behavior; skills; social; tenure track; uptake

PROJECT SUMMARY AND ABSTRACT Alcohol is the most prevalently used substance among gay and bisexual men (GBM). Additionally, alcohol is inextricably linked to GBM culture and often used as a precursor or enabler of sexual activity. Alcohol-involved sex often involves engaging in sexual behavior that places persons at higher risk for HIV seroconversion such as condomless anal sex. Pre-exposure prophylaxis (PrEP) is effective in preventing HIV-seroconversion, but recommended medication formulations are daily pills with moderately high levels of adherence to be most effective. Substance-using GBM have been shown to have lower levels of adherence compared to non-using GBM, but scant research has investigated the impact that alcohol consumption has on PrEP adherence. Therefore, the proposed study will collect pilot data to investigate the effects of alcohol use and misuse on PrEP adherence. In this mentored career development award (K01), Dr. Westmoreland will describe patterns of alcohol use and sexual behavior among PrEP-using GBM, identify the role that alcohol use plays in daily PrEP adherence using multiple methodologies to collect aggregate (e.g., 30 day) and detailed (e.g. ecological momentary assessment (EMA)) data, and contextualize PrEP non-adherence related to alcohol consumption. In Aim 1, Dr. Westmoreland will use baseline qualitative and quantitative data to describe patterns of alcohol use and sexual behavior. She will also use the narratives from qualitative interviews to add to the growing literature surrounding barriers to PrEP uptake and engagement in the PrEP care continuum. In Aim 2, Dr. Westmoreland will use multiple sources of data—i.e. quantitative surveys, timeline follow-back interviews (TLFB), diary entries collected twice-weekly for 10 weeks (i.e. EMA data), and dried blood spot (DBS) specimens for alcohol and PrEP adherence monitoring—to quantitatively identify the role that alcohol plays in daily PrEP adherence. By using multiple data collection techniques, she will also be able to pinpoint and validate estimates of alcohol use and PrEP adherence. In Aim 3, Dr. Westmoreland will use qualitative data from follow-up interviews to contextualize PrEP non-adherence related to alcohol consumption. Additionally, she will use these follow-up interviews to help characterize participants’ perceived changes in risk over the follow-up time period that could lead to deviations from daily PrEP use. Dr. Westmoreland will build on her prior training as a STI and HIV epidemiologist to expand her expertise into alcohol research and develop new analytical skills needed to conduct impactful sexual behavior research. These skills will include collecting and analyzing qualitative data; working with EMA, TLFB, and DBS data; implementation science, grant-writing, and scientific communication. Through methods coursework and workshops, alcohol-focused workshops and seminars, mentorship, and professional meetings, Dr. Westmoreland will gain the skills she needs to apply for her first R01 grant and pursue a career in HIV prevention research as a tenure-track principal investigator.

项目摘要和摘要 酒精是同性恋和双性恋男性（GBM）中最普遍使用的物质。另外，酒精是 与GBM文化无关紧要，经常用作性活动的前体或推动者。涉及酒精 性通常涉及从事性行为，使人们处于较高的HIV血清转化风险 作为无避孕套的肛交。暴露前预防（PREP）可有效预防HIV - 旋转转化，但 推荐的药物配方是每天的药丸，最高水平的粘附性最多 有效的。与非利用相比，已证明使用物质的GBM具有较低 GBM，但很少研究调查了酒精消费对准备依从性的影响。 因此，拟议的研究将收集试点数据，以调查酒精使用和错过的影响 准备依从性。在这个问题的职业发展奖（K01）中，威斯特摩兰博士将描述模式 在使用GBM中，饮酒和性行为的使用和性行为，确定酒精使用在每天的作用 使用多种方法收集聚集物（例如30天）并详细的准备依从性（例如生态学 瞬时评估（EMA））数据，并将与酒精消费相关的不遵守性上下文化。 在AIM 1中，Westmoreland博士将使用基线定性和定量数据来描述酒精的模式 使用和性行为。她还将使用定性访谈中的叙述来增加 围绕障碍的文献，以吸收和参与预先护理连续体。在AIM 2中，博士 威斯特摩兰将使用多种数据来源 - 即。定量调查，时间表跟随访谈 （TLFB），日记条目每周两次收集10周（即EMA数据）和干血点（DBS） 酒精和准备依从性监测的标本，以定量确定酒精在 每日准备依从性。通过使用多种数据收集技术，她还将能够查明和 验证饮酒和依从性的估计。在AIM 3中，Westmoreland博士将使用定性数据 从后续访谈到与饮酒有关的不遵守情况的上下文。此外， 她将使用这些后续访谈来帮助参与者的风险变化对 后续时间段可能导致偏离日常使用。 Westmoreland博士将在她的先前建立 作为性传播感染和艾滋病毒流行病学家培训，以将其专业知识扩展到酒精研究并开发新的 进行有影响力的性行为研究所需的分析技能。这些技能将包括收集和 分析定性数据；使用EMA，TLFB和DBS数据；实施科学，授予写作以及 科学交流。通过方法课程和研讨会，以酒精为中心的讲习班和 SEMIAR，MENTALSHIP和专业会议，Westmoreland博士将获得她申请的技能 她的第一个R01赠款，并作为终身制首席研究员购买了艾滋病毒预防研究职业。